Hypertension, a widespread disorder of unknown cause, is responsible for over 200,000 deaths in the United States alone each year due to heart attack, stroke, and end stage renal disease. Population-based epidemiologic studies, adoption studies and twin studies have demonstrated a strong genetic component to hypertension.
Glucocorticoid-remediable aldosteronism (GRA) is a disorder responsible for a form of hypertension. This disease is characterized by variably elevated levels of aldosterone, an adrenal gland steroid which regulates sodium-potassium metabolism, and high levels of the abnormal adrenal steroids, 18-hydroxycortisol and 18-oxocortisol.
Currently the two ways to diagnose GRA require either measurement of aldosterone levels before and after administration of a glucocorticoid drug (e.g. dexamethasone), or measurement of 18-oxocortisol, 18-hydroxycortisol and the ratio of 18-oxocortisol to tetrahydroaldosterone in a 24 hour urine collection. Both of these tests are cumbersome and expensive and the latter test is available in the United States in only a few laboratories.
Due to the difficulties associated with diagnosis of GRA, it is most probably an underdiagnosed disease. A simple, widely available test for GRA would facilitate early diagnosis and treatment for those afflicted with GRA which would be extremely beneficial since the hypertension associated with the disease is often severe, dating from early childhood.